How do people who've taken it for most of their adult life cope with adderall usage? I mean, how necessary of a drug does it seem to be -- or, to put it another way, how bad are the withdrawals, compared to antipsychotics, painkillers, etc?
And if you've lived with adderall usage, do you chronically feel like you have a reduced appetite and all the other kinds of symptoms? I've heard that happens for people who take the drug on an occasional/recreational basis, but I wonder how the side-effects feel for people who are more "on" Adderall than off of it in their normal lives.
You need to qualify your question a bit more. People with ADHD experience it differently than people without ADHD generally.
For me, withdrawals after long term use (continuously taking it for 2-3 weeks or more) are generally over a three day period. The end of the first day you really start feeling it. The second day you will be dragging, all day. The third day is similar to the first. After that, you're back to yourself, more or less.
Short term (day to day) withdrawals are a bit different. The "zombie" effect doesn't really occur until later in the day. It goes down with long term use. Often times, the zombie effect is actually due to a bad sleep schedule versus the drug, at least in my experience. Short term withdrawals are more pronounced in the first 2-3 weeks of taking it.
The apetite thing is true and false. Long term, it goes away a bit. I lost weight the first 5 months, gained it back slowly. It took about a year and a bit of consciousness to normalize.
Withdrawal symptoms are similar if using Adderall XR, except they are over a longer period of time. Adderall XR is much harder to dose right, and leads to much worse sleeping habits IMO.
For it to be effective with my ADHD, I had to take large doses. 40mg/day (instant release) was the minimum, 60 mg the usual. I've taken over 160mg in a two day period more than a few times.
Adderrall gave me headaches though at useful dosages. At first, I realized part of this was because of a decreased apetite, but even after mitigation of that (remembering to eat), I still had them.
I took Adderall over a 4 year period. Experiments with purely non-stimulant medicinces was over about 6 months. The latest combination I've been using for about a year.
"People with ADHD experience it differently than people without ADHD generally."
I generally disagree with this statement. I don't think that the subjective experience of low-dose stimulants is terribly different between people with and without ADHD. I think that those with ADHD are unable or unlikely to reach a similar state of concentration without low-dose stimulants, however.
Yes...I know the "do you really have ADHD?" question is not an easy or clear one. I was more interested in the side effects of continual use of the drug...Nearly all of the media mentions of the drug deal with people who use it periodically or who are prescribed the drug during a significant volatile period in their life (i.e. college).
Of course, selection bias would also indicate that media mentions of Adderall would come from people who've faced drastic side effects. But I've rarely read from people who've taken the drug 20+ years. And I'm interested in not just what happens if you decide to quit...but if you haven't ever quit, what side effects you tolerate day-to-day?
I have taken Adderall now for about a year, and while I have reduced appetite it is not all that bad, I still eat the necessary amount of food, in reality it has been helping me lose weight healthily since I stopped eating while bored ... since I am bored less and can focus on the task at hand. I take 10 mg twice daily.
I can go on and off Adderall with minor issues. The only issue when I go off Adderall for a day or two (they call them holidays, doctor recommended) is that I lose the effects it gives me (ability to focus) and it makes me feel slightly depressed (it helps regulate dopamine). Besides that no ill-effects, and I am aware after going off the Adderall that I will feel slightly depressed.
I've also gone entire weeks to a month without, when I am not required to focus then I can choose not to take it.
Although I do understand where the addictiveness comes in, that feeling of slight depression after going off it can be enough for most people to want to continue taking more, but I don't have an addictive personality (I've been able to start/quit smoking/drinking/soda (sugar/caffeine)/gambling/gaming (WoW) without issues). There are definitely people I know that do have addictive personalities that wouldn't be able to stop themselves.
Without it I simply wouldn't be able to function as well as I do now and I am pretty sure that I would have lost my job. It has given me a way out of the brain fog, a clarity of mind. I feel free from my mind at the end of the day and no longer have trouble falling asleep. I sleep better, much better. I worry less, and am able to prioritize and put less important things to the back of my head to process or deal with another time. With my ADHD that would always be problematic, I wouldn't be able to pay attention in meetings or conversations because I'd be working on two or three other things. I'm more aware when I am not paying attention or elsewhere and am able to voice it, something my friends/colleagues appreciate since it means they don't have to repeat the same thing over and over to me =).
Yes, Adderall gives me an energy boost as well, but it is actually less of an energy boost than from all the coffee and soda I used to drink while I was in college.
I am not saying Adderall is the end all be all drug, I wouldn't even recommend it for most people, I won't sell or give away the drugs I have, not only for the penalties it carries, but also because I know how drugs can be addictive and how those can destroy a person. If I could function properly in society without it, I would drop it in a heartbeat.
The extended release (XR) formula would help me for the first half of the day, but after about noon all effects would have worn off. Asked my doctor to change from 20 mg XR to 10 mg twice daily.
And no, it is not a whole lot, and I am trying to keep it that way. As mentioned before, if I could do without it, I would.
Why do you presume to know what is/isn't good for me, my ADHD, and my employer with only that what I have written above.
Adderall occasionally wouldn't help me complete the tasks I have to complete. I take it as the doctor has prescribed it to me. I make sure to take breaks from it (and I schedule those with work, so they know that during that week/two weeks I am going to be distracted, have trouble concentrating and it is best to let me be and bite into a hard problem and figure it all out). I have been taking the same dose for a year now, I know its effects, I know how it affects me.
I don't use Adderall as a pick-me-up, or to cram for an exam, I use it as a daily medicine because it helps me do my work. Please don't tell me what I should or shouldn't do, or that my job is not for me. I love the work I do, I enjoy working with the people I work with and learn more than I could have ever imagined. Adderall helps me through the non-exciting parts, it helps me keep focused in design meetings, it helps me keep focused on finishing the last part of the project where there is no challenge left, it helps me be able to think clearly and reason without being distracted by other projects and things I enjoy.
The only reason I think that without Adderall I would have lost my job is that it allowed me to do all those other tasks that were not interesting that still need doing. A worker that can do the hard tasks but leaves projects unfinished is useless. When a worker can't even stay focused long enough on work to be a participant in a meeting regarding new features/design that is a problem, especially when writing new software. I can learn new technologies and pick things up almost instantly, I can see my code, see how things fit together, but once the hard part is done and the rest is just rote coding, my mind goes onto new and better things. Adderall lets me focus on writing good API documentation, it lets me focus on designing the last 10% of a library to be excellent.
I don't know how to explain it to you. You have your notions of Adderall and how it should be used, and I doubt a comment from a fairly faceless person will persuade you one way or another. What I do know is that Adderall has helped me tremendously, and has helped me accomplish things I didn't think I was capable of before.
I may not be quite who you're looking for, but I think I'm in the ballpark.
I've been taking methylphenidate (ritalin) since I was about 10 years old, though I've recently switched to Vyvanse. This is what I can say about my experience.
I took methylphenidate in two forms, a short acting tablet that lasted for a ~4 hours and a proprietary time release capsule called Concerta that lasted for ~9 hours.
As a kid, for the first few years taking it there was a massive difference between me under it's effects and me without it. I totally remember feeling like I could focus on anything I wanted and completely block out everything else. Also, I remember my appetite being hugely affected, where I could ignore eating for quite a while and not really feel affected.
However, as time passed, I noticed two things:
1. The medication didn't affect me as much as it used to.
2. When off the medication, I wasn't as distracted.
In fact, by the time senior year rolled around, I could tell when I was under the effects of the medication, but not by a huge amount.
This August, after a recommendation from my doctor, I switched to Vyvanse instead of Concerta as my long-acting medication. For me, this has actually been very good. It's a much "gentler" effect than what I remember Concerta being like, in that I don't feel like the guy in "Limitless". I feel much more like my "normal" self but with my mind just slightly more organized. I feel like it's the right balance for me.
On the downsides: for me, it's totally impossible to sleep under the effect of any of the medications I've mentioned above. I can't sleep a wink. The author's description of "mind and heart racing" seems pretty accurate, though that only seems to be the case when I actually try to go to sleep. Also, now that I've switched to Vyvanse I am back to having less of an appetite than I used to. Not quite like when I first started on Concerta, but also not "normal."
I took adderall (under the direction of my doctor, naturally) as an adult for around two years. Getting off it had zero side effects or withdrawal symptoms for me, other than the fact that extraordinary focus and concentration were suddenly difficult again.
Same here. I've had ADHD for my entire life, but I seem to be able to just go on and off of it whenever I want and the only side effects is that I no longer have the benefits. In fact, I regularly do just stop taking it for time to time when I need to be more creative rather than more focused.
Myself as well. The only difference is that I have a greater appetite when I'm off it. Considering that I am overweight by just about any metric, that isn't a totally bad side effect, because I don't stop eating, I just don't eat as much when on it.
Someone very close to me had been on it since she was 12. She's 23 now and stopped last fall.
Due to her tolerance, she'd been on very high doses for basically a decade.
After stopping, sleeping for 16-18 hours a day was the norm for about a month- but just getting to that point, first she had to cope with a weeklong psychotic break.
It causes some serious dopamine desensitization after extended use. Depression is common among withdrawl symptoms.
Hi, I've taken Adderall responsibly (low-dose instant release, once a day, regularly, under GP direction) for about 5 years. I usually don't take it on the weekend. The 5 years before that, I did the same, except with recreational abuse of much higher doses, and lots of late-night binges. (Hey, I had a lot of college/MMORPG playing/hobby game programing to do.)
I have zero withdrawal symptoms when I stop taking it (as I often do when going out of town, going on vacation, long weekend, etc.) and only have a temporarily reduced appetite (i.e. uninterested in lunch). I don't feel that it currently has any negative impact on my life, whatsoever.
The years where I would stay up for 30 hours programming were a lot of fun, and I definitely don't regret them -- but I do feel that they took a bit of a mental and physical toll. Also, in hindsight, it's easy to see that Adderall benders really sap your creativity. It's nothing to rewrite the same code over and over for 30 hours -- if you'd just gotten some sleep like a normal human you would have quintupled your productivity.
Side effects: Appetite was severely reduced for the first few weeks, but now I eat normally at meal times (though I don't snack the way I did before). Sleep is fine, no head aches. A slightly elevated blood pressure from before, but not worrisome. However, I am starting to watch sodium intake to combat this. My doctor sees no reason for me not to take Adderall long term.
General experience: Much less anxious and stressed than before, when I was always scared of losing my job. The effects described in the article are much exaggerated from my experience, probably due to the quantity she was consuming. More focus has made work much more fascinating, and led to several small side projects. Social life is better, mostly due to better defined work hours and less anxiety.
The author of the article was fairly stupid- the side effects of Adderall are well known and easily searchable, and she clearly abused her (already high dosage) prescription. Some common sense and restraint would have saved her worlds of pain.
I've taken adderall on and off for 7 years, and I'm 27. In my opinion, ADHD is often a fuzzy diagnosis, but I would say that I'm legitimately classified as someone with mild ADHD. Many of my closest friends have also been people with ADHD, and we've talked a lot amongst ourselves over the years about the effects of the drug. I've noticed a lot of patterns, and determined my own set of best practices:
- Take your adderall in the morning. If you take adderall later in the day, it can affect your sleep schedule. If you don't sleep well, you may find yourself wanting to take more adderall to compensate for your lack of sleep the next day, and so begins a snowball effect that inevitably ends with a crash, and a net a loss of productivity.
- Extended release works better for me, and it has much less addictive potential than "instant release."
- Determine your personal minimum effective dose. Don't trust what the doctor happens to prescribe you to be the precisely perfect dose for you. There is most certainly a point of diminishing returns for net productivity gains. Higher doses have higher side effects.
- There are social consequences. If you'll allow me a moment of hippie speak, I'd say that adderall makes your mind resonate at a different frequency than that of regular humans. It's not so easy to establish rapport when you're not even operating on the same frequency.
- Long-term productivity gains for what I'll call production tasks is questionable. For boring work that just needs to get done, suck it up and just do it. Learn the Pomodoro technique, and improve your general capacity to focus by practicing meditation (if you have mild ADHD like me - I can't speak for people who have moderate or severe ADHD).
- Adderall works for me as an excellent tool for expanding production capability. If you have a repetitive business task that you can potentially automate, adderall works very well to help you think through automating it.
Due to the social side effects and my dislike for the inevitable down cycles (end of the day or off days) associated with regular use, I currently limit myself to use once a week. I use it ONLY to organize my week ahead of time, and to increase my production capability (learned this phrasing from Stephen Covey) by automating repetitive tasks. This is the system I've settled on after 7 years of trying different routines.
I could really say a lot more my experience with this drug, but alas I'm not on it right now :) If anyone has more questions I'm happy to follow up.
"How do people who've taken it for most of their adult life cope with adderall usage? I mean, how necessary of a drug does it seem to be -- or, to put it another way, how bad are the withdrawals, compared to antipsychotics, painkillers, etc?"
I'm 36 and I've been taking Adderall approximately since I was 32. So I've lived most of my life without it.
I've never smoked and I've never been on antidepressants or any other psychiatric drugs so I have a limited number of reference points as far as addiction/withdrawal goes. I have had an off-again, on-again caffeine addiction. In my experience, Adderall is significantly less addictive than caffeine.
Quitting Adderall is easy in my experience. I take less on the weekends, and on several occasions I've had no problems tapering my Adderall dosage down to zero over the course of 3-4 days just so I could do a little "reality check" and see for myself if I'm truly better off while taking it.
Adderall is not a medication that really lends itself to abuse in the sense that you want to cram mouthfuls of it into your body or anything.
In some ways, Adderall is very comparable to caffeine -- the first few times you take it, you feel a bit of a rush, but your body acclimates to it rather quickly and you stop feeling it. Unlike caffeine, you don't typically get the same sort of "crash" an hour later.
Though I have pretty poor impulse control at times, I've had no problem moderating Adderall usage. My psychiatrist, after a year or two of developing trust in me, actually prescribes me twice the dosage I need (30mg daily instead of 15mg daily) because he knows it will last me twice as long and therefore I can save myself some insurance co-pays for office visits. :)
I've never been on antidepressants but I've watched friends struggle with getting off of antidepressants, and I've also seen what they're like after missing a few doses. They have found themselves in really rough shape unless they carefully taper their dosages down over the course of weeks or even months. From those secondhand observations, I feel Adderall is not even close to being in that league when it comes to withdrawal.
"And if you've lived with Adderall usage, do you chronically feel like you have a reduced appetite and all the other kinds of symptoms?"
It hasn't affected my appetite much. (I kind of wish it had!) The main negative side effect is that Adderall makes me more high-strung. However, falling behind on one's obligations due to untreated ADHD can also negatively one's mood, to say the very least.
When you take amphetamine every day, you incur a debt that can only be repaid by taking a break. If you don't pay back the debt, you enter the risky business of increasing your dose and dancing with the loan shark that always collects.
So I imagine most chronic amphetamine users like myself have a healthy relationship with it or we'd burn out like the girl in the article which is a rather familiar tale of classic abuse.
Amphetamine side-effects never go away. If you're tolerant of the side-effects, you're tolerant of the very effect you're taking it for. In fact, the side-effects are a good indicator of where you are in a dose. The onset of cotton mouth is what reminds you that it's working.
Even after a month or two of constant amphetamine use, withdrawal for me is at most a week of some scatterbrained lethargy (paying back that debt). The demons of amphetamine are the side-effects and psychological dependency, not the weak withdrawal. Unfortunately you're susceptible to those demons no matter how long you've been prescribed.
And if you've lived with adderall usage, do you chronically feel like you have a reduced appetite and all the other kinds of symptoms? I've heard that happens for people who take the drug on an occasional/recreational basis, but I wonder how the side-effects feel for people who are more "on" Adderall than off of it in their normal lives.